SEXUAL HEALTH AND EMPOWERMENT [SHE]
EXECUTIVE SUMMARY
INTRODUCTION
The Sexual Health and Empowerment (SHE) project, funded by Global Affairs Canada (GAC) in partnership with Oxfam Canada (OCA), Oxfam Pilipinas (OPH), Jhpiego, and eleven local women’s rights organizations (WROs) and civil society organizations (CSOs), aimed to improve Sexual and Reproductive Health and Rights (SRHR) in marginalized communities in the Philippines. The project, implemented from 2018-2025, sought to address unmet family planning needs, reduce teenage pregnancy rates, and promote gender equality, particularly for women and adolescent girls. In addition to focusing on individual and community-level engagement, the project strengthened local WROs and CSOs to advocate for SRHR and gender-based violence (GBV) prevention.
The SHE project adopted a holistic approach to tackle systemic SRHR barriers by combining bottom-up advocacy to drive policy change. It spanned seven years and targeted conflict-affected regions in the Philippines that faced significant social and cultural barriers to accessing reproductive health services.
This executive summary provides an overview of the project’s impact, as assessed through an external evaluation. The evaluation utilized a mixed-methods approach, incorporating both quantitative and qualitative techniques, and adhered to the Organization for Economic Cooperation and Development’s Development Assistance Committee (OECD/DAC) criteria. It employed a concurrent embedded design, prioritizing qualitative methods while embedding quantitative data within these findings. The evaluation was both summative—assessing whether the project’s objectives were achieved—and formative, focusing on lessons learned and the effectiveness of strategies used throughout the project.
PROJECT OVERVIEW
Pillar 1: Community-Level Engagement and Advocacy
This pillar focused on direct engagement with individuals and communities to raise awareness and support for SRHR and gender equality. Through grassroots initiatives, the project empowered women, girls, and communities to take control of their reproductive health, improve health-seeking behavior, and challenge harmful social norms.
Core activities under Pillar 1 included:
• PEER EDUCATION PROGRAMS: Training adolescents to advocate for SRHR, promoting family planning, healthy behaviors, and GBV prevention.
• HEALTH PROVIDER TRAINING: Improving gendersensitive, inclusive, and non-judgmental healthcare delivery, particularly in rural and underserved areas.
• ENGAGEMENT WITH MEN AND BOYS: Involving them in family planning decisions and challenging gender stereotypes that contribute to poor reproductive health outcomes.
• COLLABORATION WITH RELIGIOUS AND COMMUNITY LEADERS: Fostering support for SRHR in culturally and religiously conservative regions, such as the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM).
The project worked with seven local partner organizations—AMWA, Family Planning Organization of the Philippines (FPOP), Mayon Integrated Development Alternatives and Services (MIDAS) Inc., Pambansang Koalisyon ng Kababaihan sa Kanayunan (PKKK), Sibog Katawhan Alang sa Paglambo (SIKAP) Inc., and United Youth of the Philippines-Women, Inc. (UnYPhil Women)—and one international partner, Jhpiego, to implement activities under Pillar 1 in the targeted provinces and municipalities.
Pillar 2: Institutional Strengthening and Policy Advocacy
This pillar aimed to build the capacity of local WROs, institutions, and alliances to advocate for improved SRHR services and policies. It included collaborating with four local partner organizations and networks— Davao Medical School Foundation Inc. (DMSFI), Friendly Care Foundation, University of the Philippines Centre for Women’s and Gender Studies (UPCWGS), and Women’s Global Network for Reproductive Rights (WGNRR)—to integrate SRHR services into local health systems, strengthen partnerships between grassroots SRHR networks and advocacy groups, and develop capacity for policy reforms.
Core activities under Pillar 2 included:
• CAPACITY-BUILDING WORKSHOPS: Training local organizations on SRHR advocacy, project management, and GBV prevention.
• POLICY ENGAGEMENT AND ADVOCACY: Working with local governments to institutionalize SRHR services and integrate them into annual development plans and budgets.
• SUPPORT FOR ADOLESCENT-FRIENDLY HEALTH SERVICES: Ensuring that young people could access comprehensive reproductive health services in safe and supportive environments.
These two pillars worked synergistically to address both immediate SRHR needs and long-term institutional sustainability.
The SHE project operated under two major pillars:
EFFECTIVENESS
3.1 Ultimate Outcomes
3.1.1. Reduction in Unmet Family Planning Needs
% of women with unmet need for FP including modern methods Girls: 5%
25% Girls: 13.3%
The SHE project significantly influenced health-seeking behavior and addressed unmet family planning (FP) needs among women and adolescent girls, as illustrated in the table above. Several key strategies contributed to these successes:
• EXPANDED CONTRACEPTIVE DISTRIBUTION: A major breakthrough in reducing unmet FP needs was the expansion of contraceptive distribution in previously underserved areas. The project collaborated with health providers to distribute contraceptives through various channels, including Rural Health Units (RHUs), community health workers, and Adolescent-Friendly Health Facilities (AFHFs). This multichannel approach ensured that even women in remote regions could access necessary resources.
• MALE INVOLVEMENT IN FAMILY PLANNING: In many communities, traditional gender norms placed family planning decisionmaking solely in the hands of men. Recognizing this barrier, the project introduced targeted interventions to engage men in family planning discussions. Male peer educators were trained to lead conversations about the benefits of FP for family health and economic stability. By involving men, the project helped dismantle traditional barriers and supported women’s autonomy over their reproductive health choices.
At present, the pills are running out in the barangay unlike before when they would just expire, which is one of the tangible outcomes of the SHE Project.
- COMMUNITY LEADER, BICOL
At present, the pills are running out in the barangay unlike before when they would just expire, which is one of the tangible outcomes of the SHE Project.
- COMMUNITY LEADER, BICOL
• CULTURAL SENSITIVITY IN FAMILY PLANNING MESSAGING: In conservative regions like BARMM, religious and cultural sensitivities posed challenges to promoting contraceptive use. The project engaged religious leaders to communicate the importance of family planning within the context of religious teachings. Quranic verses supporting birth spacing and responsible parenting were incorporated into discussions, easing community resistance and fostering acceptance.
By expanding service delivery, promoting male involvement, and employing culturally appropriate messaging, the SHE project effectively reduced unmet FP needs.
In Eastern Visayas, a representative noted that the predominance of female service providers can make men feel embarrassed when seeking FP services. This issue is more pronounced in Muslim areas like BARMM, where traditional masculinity norms discourage men from accessing FP. A representative from Ganassi explained, “Men
feel shy and might think it’s quietly insulting to ask for FP services. Many believe FP is about stopping birth altogether, which they find offensive.”
3.1.2. Reduction in Teenage Pregnancy Rates
% of girls who reported to be pregnant at the time of baseline and endline surveys
FHSIS 2023 data revealed a decrease in the teenage pregnancy rate (TPR) for 10-19-year-olds across all project sites, from 2,281 in 2019 to 1,598 in 2023. Despite this improvement, TPR remains higher than desired in some regions due to various socio-cultural factors. Survey data confirmed this trend using a proxy indicator asking adolescents about pregnancy during data collection. Only 2.9% of teenagers reported being pregnant at the time of data collection surpassing the target of 3.2% and marking a significant decline from 7.4% at baseline.
The SHE project positively impacted adolescents’ access to SRHR services, with most regions reporting significant progress, except BARMM. According to a BARMM representative, the community’s negative perception of unmarried boys and girls visiting clinics— even for counseling—remains a barrier. Stigma around accessing such services hinders adolescent engagement. In other regions, however, adolescents are increasingly turning to teen centers and Adolescent-Friendly Health Facilities (AFHFs) for age-appropriate SRHR information. Youth in Caraga, Eastern Visayas, and Northern Mindanao reported that private consultation rooms and attentive care positively influenced their service-seeking behavior.
Key strategies that contributed to improved SRHR service-seeking among youth include:
• COMPREHENSIVE SEXUALITY EDUCATION (CSE): CSE integrated into school curricula and youth groups equipped adolescents with essential knowledge about SRHR, including safe sex, consent, and contraception. Adolescents who participated in CSE reported increased contraceptive use and a better understanding of SRHR topics.
• YOUTH-FRIENDLY SERVICES: The establishment of AFHFs provided adolescents with confidential, safe spaces for contraceptive access, counseling, and SRHR information. These centers, placed in schools and communities, reduced the stigma of seeking help.
• PARENTAL AND COMMUNITY ENGAGEMENT: Resistance from parents and communities posed a challenge. The project engaged parents in open dialogues about the importance of SRHR education, easing concerns and building support for CSE and family planning services for adolescents.
3.1.3 Improvements in Positive Attitudes Toward SRHR
Another critical outcome of the SHE project was the significant shift in attitudes toward SRHR among women, men, adolescents, and community leaders. Attitudes toward reproductive rights, family planning, and gender equality showed marked improvement by the end of the project.
Findings:
The SHE project contributed to a significant shift in attitudes toward SRHR, including family planning, reproductive rights, and gender equality. This shift was evident among women, men, adolescents, and community leaders by the project’s conclusion.
1. INCREASED REPRODUCTIVE AND SEXUAL AUTONOMY AMONG WOMEN
The project empowered women to make informed decisions about their reproductive health, such as when to have children and how to space pregnancies. This increased the use of RHU services and improved family well-being. A participant from BARMM stated,
“Understanding my right to decide when to have children allowed me to space out my pregnancies, improve my health, and provide better care for my children.”
The Sexual Autonomy Index improved from 23% at baseline to 38%. However, sexual initiation remains low at -27%, with negative scores for girls. Despite this, sexual negotiation and communication scored higher at 62%, and 80% of participants supported accessible counseling services.
2. SHIFT IN YOUTH MINDSETS ON SRHR ISSUES
Adolescents showed a positive change in attitudes, including rejecting early marriages and understanding family planning. Peer-led Usapan (discussion) sessions empowered youth to make informed health decisions. One participant said,
“The discussion on child marriage was an eye-opener to the realities adolescents face.”
3. HIV AWARENESS AND PREVENTION
The project raised HIV awareness, promoting safe sex practices and testing. A participant reflected, “I learned about HIV and STIs that can be acquired through sexual intercourse, so it’s important to use condoms.”
By the end of the project, 93.1% of participants were aware of HIV/AIDS, with 78.6% understanding the importance of testing.
4. PROMOTION OF GENDER EQUALITY AND SHARED RESPONSIBILITIES
The project challenged traditional gender roles, promoting shared household responsibilities. Male participants in Bicol noted,
“The SHE Project reminded us that men and women share responsibilities at home and in the community.”
This led to reduced Gender-Based Violence (GBV) and increased power of women decision-making.
5. REDUCED GBV AND STRENGTHENED REFERRAL PATHWAYS
Strengthened GBV referral pathways through Multi-Disciplinary Teams (MDTs) ensured survivor-centric care. Jhpiego led efforts to coordinate services, with peer educators supporting timely referrals. One RHU representative said,
“Previously, many clients sought help for abuse, but now fewer do because incidents of violence have decreased.”
Key Drivers of Change
• PEER EDUCATION AND YOUTH ENGAGEMENT: Peer-led sessions, such as Usapan Serye (Conversation series), helped adolescents make informed decisions about SRHR, reducing early marriage, teenage pregnancy, and HIV.
• CULTURAL SENSITIVITY AND COMMUNITY INVOLVEMENT: Engaging religious leaders and community stakeholders broke SRHR taboos. A woman from Caraga shared, “Initially, I found these topics inappropriate, but now I am open and more mature discussing them.”
• GENDER-RESPONSIVE TRAINING: Training for health and community workers improved gender dynamics and shared household responsibilities, particularly in Northern Mindanao and Bicol.
• IMPROVED REFERRAL SYSTEMS FOR GBV: Establishing multidisciplinary teams (MDTs) streamlined GBV case management, reducing survivor trauma by minimizing the need to repeat their experience across multiple services.
• MEDIA CAMPAIGNS AND OUTREACH: Mass media, radio programs, and social media outreach raised awareness about SRHR and GBV prevention, reaching diverse audiences and normalizing discussions around sexual health.
GBV WATCH GROUPS: A UNIQUE AND EFFECTIVE INTERVENTION BY PKKK
PKKK’s establishment of GBV Watch Groups, a model born after Typhoon Yolanda in 2013, has yielded remarkable results and was successfully integrated into the SHE project. These groups, distinct from multidisciplinary teams (MDTs), play a vital role in making the referral system effective beyond paperwork. With three training modules covering gender, SRHR, and GBV concepts, the watch groups have built strong connections with municipal social welfare offices and MDTs, enhancing community response to GBV.
The impact of these groups has been significant, fostering greater awareness and transforming GBV into a central community concern. In Dimataling, the GBV Watch Group president shared,
“SHE significantly enhanced our skills and knowledge about VAWC and rape cases. Their support has been the backbone of our advocacy efforts.” Similarly, a representative from Clarin noted, “The training from SHE has given me the confidence to disseminate accurate GBV information effectively.”
ENHANCED GBV RESPONSE IN BULUSAN
In Bulusan, a partnership between MIDAS and the local government has strengthened the capacity of the VAWC Desk Federation. A Memorandum of Agreement with the Mayor provided the Federation with a private office, counseling space, and a halfway house for survivors. This partnership improved confidentiality practices, ensured consistent support through trained personnel, stabilized the frequent turnover of VAWC officers and created a more survivor-centered approach.
3.2 Intermediate and Immediate Outcomes
3.2.1 New FP Acceptors by Modern Methods of Contraception
Over the past six years, there has been a notable increasing trend in the number of new acceptors. By the end of the SHE project, the number of new FP acceptors reached 24,7871. The project surpassed its Year 6 endline target of 5,209 by 31%, reaching 6,824. Progestin-only subdermal implants (PSI) were the most popular method, followed by injectables and oral pills. Permanent methods such as No-Scalpel Vasectomy and Bilateral Tubal Ligation had low uptake. A steady increase in PSI use reflects a shift toward longer-acting contraceptives.
Both FHSIS and survey data revealed mixed trends in new FP acceptors across regions. A survey proxy indicator showed a decline in FP usage from baseline to endline: girls (87% to 79%), women (68% to 65%), boys (40% to 32%), and men (69% to 32%). BARMM saw significant increases in Bongao due to enhanced PSI services, while Ganassi lagged due to low FP prioritization. Region 5 experienced slight growth in Prieto Diaz and Bulusan, but declines in Mobo due to limited health provider training. Region 8 showed the highest rise in Sta. Margarita, driven by outreach and FP commodity distribution, despite a COVID-19 dip. Region 9 faced declines due to FP commodity stockouts, and Region 10 showed mixed results, with Ozamiz City excelling due to PSI training. Region 13 saw high acceptor numbers in 2021 but later declined as the target population was reached.
Although the target for RHUs with three or more available modern contraceptives was not fully met, with 16 out of 17 achieving the goal, stockouts in some regions highlighted the need for better procurement processes under the new Mandanas Rule. These gaps underscore ongoing challenges in ensuring consistent contraceptive availability.
3.2.2 Access to Gender-Responsive Reproductive Health Services
At 65,994, the project surpassed its target for women accessing gender-responsive reproductive health services, while the target for men fell short by 9.7%. Although there was a slight rise in contraceptive use in 2023 (65,994) users, the contraceptive prevalence rate (CPR) remained challenged by regional population growth of women of reproductive age, particularly in Regions 5 and 8. Modern contraceptives like oral pills (36%-38%), injectables (20%-24%), and PSI (17%) remained most popular, while permanent methods had low uptake, limited to medical missions. COVID-19 efforts, including PSI distribution and provider training, boosted usage. This highlights the need for continuous improvement in service accessibility and contraceptive distribution, particularly in Regions 5 and 8, where CPR trends varied due to stockouts and provider capacity issues. ACCESS TO REPRODUCTIVE
TOP 3 PREFERRED CONTRACEPTION METHODS
Nineteen out of twenty Rural Health Units (RHUs) met the project’s standards for youth-friendly and genderresponsive SRHR services. Service providers gained confidence and skills in gender-sensitive care after comprehensive Gender Transformation on Health (GTH) training. In Sumilao, most staff were trained in adolescentsensitive approaches, boosting their ability to handle gender-related issues. Service-seekers confirmed the positive impact, with women and girls sharing their positive experiences in accessing services, and male participants across all regions praised the RHUs for providing respectful, confidential, and equitable care for all, including LGBTQIA+ members.
3.2.3 Knowledge of SRHR Service Access
The project significantly increased knowledge of where to access SRHR services. By the endline, awareness among women and girls increased dramatically from baseline levels, while men and boys also saw substantial gains, though at a slower rate. Awareness of FP services at Barangay Health Stations (BHS) remained the most common, with RHUs being the second most accessed service point.
The project has encouraged a shift toward using formal health services like RHUs, BHWs, and midwives for SRHR information, reflecting increased trust in these reliable, accessible sources. However, informal sources such as neighbors and online platforms remain widely used, especially among adolescents and in regions like BARMM, where misinformation about contraception persists.
The evaluation revealed that men prioritize accessibility and privacy, often seeking information from formal services, while women prefer local practitioners like midwives for their empathetic care. Adolescents, particularly boys, often rely on online sources, while girls turn to parents, friends, or RHUs for more accurate SRHR information.
PEER EDUCATORS: TRANSITIONING TO LEADERSHIP ROLES
The SHE project has been crucial in fostering the personal and professional growth of peer educators, many of whom have transitioned into leadership roles within their communities. Comprehensive training provided by the project equipped them with essential skills in SRHR, legal frameworks, communication, and time management, significantly boosting their confidence and leadership abilities.
A peer educator from Zamboanga Peninsula shared how the training helped her overcome nervousness and transition from a housewife to a Barangay Health Worker and official. Similarly, another peer educator credited the project for improving her time management and enabling her to handle dual roles effectively.
The project also offered practical experiences, such as leading community seminars and participating in local governance, allowing educators to apply their new skills. For instance, in Northern Mindanao, two Barangay Councillors, supported by the SHE project, ran for the council and actively advocated for SRHR.
However, peer educators faced challenges, such as balancing their pre-existing responsibilities with new leadership roles and overcoming cultural barriers. Some, initially unprepared for the workload, felt overwhelmed but adapted with support from the project. Cultural and social barriers also made the transition difficult for some, especially those with limited prior public interaction. Despite these obstacles, the peer educators have demonstrated resilience, with the SHE project providing the technical and emotional support necessary for success.
3.2.4 Inter-Agency Collaboration
The SHE project fostered 21 inter-agency collaborations between WROs, CSOs, and government agencies, reaching its target. These collaborations advanced SRHR and GBV prevention through partnerships, such as the Reproductive Health Advocacy Network (RHAN) led by FPOP. Collaborative efforts, like those between WROs and state universities, facilitated community-based responses and policy influence, evidenced by recommendations from CEDAW and the Philippine Commission on Human Rights. Initiatives like the GBV Watch Groups also aimed for endorsement by the Philippine Commission on Women, highlighting a strengthened advocacy ecosystem.
3.2.5 Increased Advocacy Capacity of WROs
The CAT4SRHR tool significantly boosted WRO confidence in advocacy. Training and organizational development activities strengthened strategic planning, financial management, and gender justice efforts across all partner organizations. For example, SIKAP and UnYPhil Women improved their advocacy capabilities, leading them to independently organize stakeholder forums and policy recommendations. Similarly, the University of the Philippines Centre for Women’s Studies Foundation (UPCWGS) benefited from institutional changes, including seminars and feminist dialogues. WGNRR improved strategic planning, networking, and their role in global SRHR platforms. DMSFI revised policies for inclusivity, integrating gender-just MEAL systems, and providing training on sensitive language for marginalized groups. Friendly Care Inc. adopted anti-discriminatory hiring policies, updated their mission to include SRHR, and improved GBV support. These changes ensure long-term sustainability and effectiveness, extending the project’s benefits beyond its immediate scope.
The evaluation noted increased self-confidence among WROs in SRHR and GBV advocacy, transforming them from passive participants into proactive leaders. Partners saw substantial gains in organizational resilience, networking, and advocacy effectiveness, as evidenced by improvements in the CAT4SRHR assessments across six key domains, including community mobilization and sustainability.
“We are running projects with other donors and partners as well, and because of the capacity enhancement and CAT4SRHR-related support and assessment, we have been mainstreaming these concepts across all programs. This has had a sustainable impact.”
– PARTNER (PKKK) REPRESENTATIVE
“We have become more strategic by mainstreaming gender and SRHR in our organizational mandate, vision, mission, and goals. These principles are now embedded in our activities as part of our advocacy. Our MEAL processes are now more gender-sensitive, and the gender justice framework has proven to be effective.
– PARTNER (UNYPHIL) REPRESENTATIVE
3.2.6 Improvements in Partners’ Knowledge-Generation Capacities
SHE partners developed 18 learning agendas, surpassing the target of 10. These agendas focus on SRHR advocacy and sustainability, supported by workshops hosted by UPCWGS and Oxfam Pilipinas. Arts-based research and creative workshops have enhanced gender analysis, knowledge dissemination, and policy influence. Initiatives like Feminist Research 101 empowered organizations, such as MIDAS, to conduct SRHR research and integrate these agendas into practice and policy.
UPCWGS also led SRHR research, resulting in knowledge products, including a book series launched in 2024. Although dissemination was delayed, mentoring efforts enabled partners like MIDAS to produce gender-focused research. UPCWGS plans to further collaborate with Oxfam Pilipinas to share findings with local leaders and elected officials, aiming to influence policy through local ordinances and sustained advocacy.
3.2.7 Advocacy and Influencing Gains
The SHE Project exceeded expectations in advocacy and influencing activities on SRHR and GBV prevention. It succeeded in fostering 75 public declarations by community influencers in support of SRHR and women’s leadership, far exceeding the original target. These actions contributed to the institutionalization of SRHR services and the enactment of relevant policies, such as anti-GBV referral systems and adolescent health initiatives in various municipalities.
Moreover, by the project’s end, 47 advocacy and public engagement campaigns were conducted, surpassing the target of 10. The Power Up! Initiative, led by WGNRR, supported 30 organizations, 15 of which received grants to strengthen their SRHR and GBV campaigns. For instance, Liyang Network’s SRHR campaign empowered women and LGBTQIA+ individuals, driving community engagement. These campaigns also contributed to legislative efforts, such as the Adolescent Pregnancy Prevention Bill.
Additionally, 37 WROs and networks reported improvements in their influencing skills, exceeding the target of 20. Through capacity-building efforts, 24 organizations gained crucial skills in identifying SRHR issues, planning advocacy campaigns, and using inclusive language. WGNRR’s strategic advocacy extended to national and international forums, contributing to significant policy progress on issues like adolescent pregnancy, the decriminalization of abortion, and SOGIESC equality. WGNRR’s participation in the Universal Periodic Review further bolstered advocacy efforts, influencing key policy discussions and legislative agendas. These outcomes reflect the project’s broader impact on advancing SRHR and GBV prevention through strengthened advocacy and policy influence.
3.3 Project Design, Coherence and Relevance
The SHE project closely aligned with national and local policies, including Gender and Development (GAD) guidelines, family planning programs, and GBV frameworks, ensuring its relevance and integration into existing initiatives. In regions like BARMM, where resistance to SRHR was high, the project successfully fostered essential discussions by aligning with local GBV policies. It supported national goals under the Reproductive Health Law and SDGs by collaborating with LGUs to improve maternal health and family planning access. A key success was embedding SRHR services into local policies, ensuring long-term sustainability, as demonstrated by Buug’s “adolescent-friendly” health facilities.
The project design aligns with the Socio-Ecological Model (SEM), addressing SRHR challenges at multiple levels. Pillar 1 focused on empowering individuals and communities, while Pillar 2 drove systemic change through advocacy, policy influence, and capacity building of WROs and CSOs. Its relevance stems from addressing specific regional issues, such as engaging religious leaders in BARMM to shift SRHR norms.
A notable achievement was the project’s inclusive design process, which incorporated input from local stakeholders and partners, fostering ownership and ensuring its adaptation to local needs. The Theory of Change (ToC) proved highly relevant, addressing demand-side social norms and supply-side capacity building in health service delivery.
3.4 Efficiency
Engaging partners early on significantly improved the efficiency of the SHE project, ensuring smooth operations and collaboration. However, challenges arose, such as a key CSO partner halting interventions in Tawi-Tawi and political instability in Ozamiz City, both of which required adjustments in strategy. Despite these setbacks, the project maintained efficient financial management, with no complaints from partners about the budget. However, concerns were raised about the inadequacy of MEAL staff, which put a strain on existing program officers. The COVID-19 pandemic caused delays, but adaptive management strategies, such as remote modalities and a no-cost extension, allowed the project to navigate these challenges effectively. Remote adaptations were positive but posed difficulties in areas with limited internet access. Hiring a regional coordinator familiar with local cultures improved coordination. Though the pandemic impacted the adoption of FP methods and SRHR services, the extension helped the project achieve its objectives.
3.5 Coordination and Partnerships
The SHE project benefited from strong collaboration and partnerships across various levels. Partners highly appreciated Oxfam Pilipinas (OPH) for their continuous support, with UnYPhil Women and PKKK praising their responsiveness and assistance in areas like financial management. Coordination with Oxfam Canada, however, was more ad-hoc, occasionally leading to communication delays.
Engagement with local stakeholders, such as LGUs, RHUs, and protection desks, was robust, with regular updates facilitating effective project implementation. Partners like FPOP highlighted the positive influence of involving LGUs in addressing issues like teenage pregnancy. Coordination with regional authorities, especially in BARMM, was identified as an area for improvement, as regional influencers sometimes opposed national laws, such as the prohibition of child marriage.
Strengthening regional and national coordination through forums, workshops, and partnerships was recommended to overcome challenges and align local ordinances with national priorities. Additionally, the project missed opportunities to intensify national-level advocacy with agencies like the Department of Health and the Women’s Commission.
3.6 Cross Learning and Synergy
The SHE project facilitated cross-sharing and learning among partners through platforms like PCT meetings and learning visits. Partners from Pillar 1 and Pillar 2 engaged in exchanges, such as AMWA adopting religious messaging strategies from another partner, which positively influenced the community’s perception of SRHR. Pillar 1 partners also conducted learning visits to observe and adopt successful practices across different regions, strengthening collaborative efforts. The collaboration between Pillar 1 and Pillar 2 partners extended to joint workshops and SRHR dialogues, creating a synergistic relationship.
Pillar 2 outcomes were foundational in equipping Pillar 1 partners with conceptual clarity on SRHR, enabling effective community interventions. The CAT4SRHR tool under Pillar 2 was crucial in deepening partners’ understanding of SRHR, which directly informed Pillar 1’s work. This synergy allowed Pillar 2 partners, such as WGNRR and UPCWGS, to engage with Pillar 1 partners for knowledge generation and advocacy strategies.
However, the evaluation found limited evidence of fully integrated advocacy efforts between national, provincial, and local levels, suggesting the need for stronger connections to maximize impact. While national and provincial advocacy influenced local campaigns, reinforcing these synergies through regular strategic sessions and integrated efforts would enhance the overall effectiveness of the SHE project.
3.7 Sustainability
The SHE project demonstrated several elements of sustainability that ensured its long-term impact, particularly through investments in health service providers, community education, and partnerships with local government units (LGUs). These strategies have laid a solid foundation for the continuation of SRHR services and advocacy beyond the project’s lifespan.
• HEALTH SERVICE PROVIDERS: One of the most sustainable aspects of the project was the investment in midwives, barangay health workers, and other healthcare providers. These individuals received training on SRHR, gendersensitive care, and adolescent-friendly services, equipping them to continue delivering high-quality care. Their enhanced capacity means SRHR services will remain available in their communities, even after the project ends.
• ADOLESCENT HEALTH-FRIENDLY CENTRES (AHFCs): The establishment of AHFCs within the communities ensures continued service provision for adolescents. These centres are staffed by trained healthcare providers who are well-prepared to address the SRHR needs of young people. As these centres are now integrated into local health systems, they will continue to operate, providing ongoing access to essential services.
• COMMUNITY EDUCATION: The project’s focus on educating the community has empowered individuals with the knowledge and skills needed to maintain SRHR awareness and advocacy. Through peer education and community-based training, the project fostered a culture of knowledge-sharing that will persist. Peer educators continue to play a crucial role in spreading information about SRHR and gender-based violence (GBV) prevention.
• LGU ENGAGEMENT:
- In SORSOGON, a local lawmaker introduced an ordinance to establish adolescent-friendly health facilities, ensuring that adolescent health remains a priority for the community.
– In BUUG (REGION 9), all barangays achieved adolescent-friendly status, ensuring that youth and women have access to SRHR services well into the future.
– In BARMM, LGUs have embraced peer educators and plan to expand their SRHR efforts to all barangays, demonstrating strong governmental buy-in and sustainability.
– In CARAGA, LGUs have integrated SRHR programs into their annual plans, providing financial support and ensuring long-term commitment.
– In some regions, such as GANASSI, LGUs are supportive but face budget limitations. External funding remains critical to sustaining SRHR activities in such areas.
• PEER EDUCATOR SUSTAINABILITY: Peer educators, who received extensive training under the SHE project, are now recognized community leaders. For instance, in NORTHERN MINDANAO, peer educators continue to lead SRHR awareness campaigns with the support of the Commission on Population and Development and the local Gender-Based Violence Watch Group.
• YOUTH-LED ORGANIZATIONS: Groups like the NORTEHANON YOUTH ADVOCATES (NYA) have gained formal recognition and financial backing, allowing them to continue advocating for SRHR and GBV prevention. The NYA, for instance, secured registration and funding from the Sangguniang Kabataan (SK), ensuring its sustainability.
3.6.1 Threats to Sustainability
While the SHE project achieved many successes, several challenges threaten its sustainability. A key concern is the ongoing engagement of peer educators, whose volunteer status makes their long-term commitment uncertain, especially as adolescents transition into adulthood. Although some barangays support peer educators, ensuring consistent recognition and integration across all regions remains a challenge. Elections pose another risk, as the turnover of trained local officials could disrupt the continuity of SRHR initiatives.
Health service provider attrition is also a threat to sustainability. To mitigate this, Jhpiego strategically trained regular LGU-employed staff in adolescent-friendly services, ensuring essential skills remain within the community. However, the voluntary nature of peer educators’ work and the uncertainty of tracking their continued involvement raise concerns.
Under Pillar 2, organizations face challenges maintaining the progress achieved through the CAT4SRHR tool, especially if experienced personnel leave. Additionally, many initiatives are reliant on external funding, and without continued financial and technical support, local CSOs may struggle to maintain their advocacy efforts. Organizations like DMSFI and FriendlyCare have implemented gender-sensitive policies, but these require ongoing reinforcement to remain impactful. The over-reliance on seed grants from the Power-Up program presents further sustainability risks, as organizations may face difficulties continuing their campaigns once funding ends.
LESSONS LEARNED 4
The SHE project generated a number of valuable lessons regarding what worked well and what challenges were encountered. These insights are critical for future SRHR and GBV programming, both in the Philippines and globally.
4.1 Effective Engagement Strategies
4.1.1 Peer-to-Peer Education as a Key Engagement Tool
One of the most effective strategies employed by the SHE project was the PEER-TO-PEER EDUCATION MODEL Adolescents are often more comfortable discussing sensitive topics, such as SRHR and contraceptives, with their peers than with adults or authority figures. The project identified influential youth in the community and trained them as peer educators to promote SRHR knowledge among their peers.
Key Lessons:
• TRUST AND RELATABILITY: Adolescents were more likely to trust and act on the information provided by their peers. Peer educators shared their own experiences with SRHR services, which made the information more relatable and less clinical. This approach proved especially effective in conservative communities where discussions around SRHR were traditionally taboo.
• SUSTAINABILITY: By training local adolescents to become peer educators, the project fostered a sense of ownership within the community. Even after the project ended, these young educators continued to serve as informal resources for SRHR information, ensuring the sustainability of the project’s outcomes.
Future projects should prioritize peer education as a central component of SRHR programming, particularly when targeting adolescents.
4.1.2. Religious and Community Leaders as Allies
Engaging religious and community leaders was another key success of the SHE project, especially in conservative regions like BARMM where religious beliefs heavily influence social norms and health-seeking behaviors.
Key Lessons:
• ALIGNMENT WITH RELIGIOUS TEACHINGS: In areas where resistance to SRHR was rooted in religious beliefs, the SHE project worked closely with religious leaders to frame family planning and reproductive rights in terms that aligned with religious teachings. For example, the project used teachings from the Quran that promote responsible parenting and birth spacing to encourage the use of contraceptives. This helped overcome community resistance to family planning and created a more supportive environment for SRHR services.
• CASCADING LEADERSHIP: Religious leaders not only endorsed SRHR messages but also actively led community discussions, cascading the messages down to other influential figures within the community. This created a ripple effect that amplified the project’s impact on community norms.
Future SRHR initiatives should continue to leverage the influence of religious and community leaders to facilitate broader acceptance of reproductive health services.
4.2 Programmatic Insights
4.2.1. The Importance of Long-Term Engagement
One of the most important lessons from the SHE project is the need for long-term engagement with communities to foster sustained behavior change. While short-term interventions may raise awareness and spark initial interest in SRHR services, they are unlikely to lead to lasting changes in attitudes and behaviors without sustained follow-up and support.
Key Lessons:
• BUILDING TRUST TAKES TIME: In regions where SRHR services were initially met with resistance, it took time for the project to build trust and normalize conversations around reproductive health. The project’s multi-year engagement with these communities allowed for gradual shifts in attitudes and behaviors. By maintaining a consistent presence in the community, the project was able to build deeper, more meaningful relationships with community members.
• FOLLOW-UP AND REINFORCEMENT: For many women and girls, accessing SRHR services was a new experience. Providing follow-up support through mobile health clinics, community health workers, and peer educators was essential to ensuring that women continued to use these services and did not revert to previous behaviors. Future programs should be designed with a long-term perspective, ensuring that interventions are sustained over several years to maximize impact.
4.2.2. Strong Partnerships with Local Government Units (LGUs)
The involvement of LOCAL GOVERNMENT UNITS (LGUS) was critical to the SHE project’s success and sustainability. LGUs that were actively engaged in the project were more likely to integrate SRHR services into their annual health plans and allocate local budgets to continue supporting these services after the project’s conclusion.
Key Lessons:
• OWNERSHIP AND SUSTAINABILITY: By building strong partnerships with LGUs, the SHE project ensured that local governments took ownership of SRHR initiatives. In several regions, LGUs incorporated SRHR into their long-term development plans and health budgets, providing a foundation for the continuation of services.
• POLICY INFLUENCE: LGUs played a key role in advocating for the integration of SRHR services into local health systems. By engaging local policymakers early in the project, the SHE initiative was able to influence policy reforms that institutionalized SRHR services within government health programs.
RECOMMENDATIONS
The evaluation of the SHE project provides a number of recommendations for future SRHR programming, particularly in contexts where cultural and religious barriers to SRHR are prevalent. These recommendations aim to enhance the effectiveness, scalability, and sustainability of future initiatives.
5.1 Programmatic Recommendations
5.1.1. Greater Integration of Men and Boys in SRHR Programs
While the SHE project made some strides in engaging men and boys in SRHR education, this area remains a missed opportunity. Future programs should place a greater emphasis on involving men and boys in family planning and reproductive health education, as their support is critical to women’s autonomy and gender equality.
Key Recommendations:
• DEVELOP FATHERHOOD INITIATIVES: Future programs should introduce fatherhood initiatives that emphasize men’s roles in supporting reproductive health and responsible parenting. By engaging men in discussions about family planning and the health benefits of birth spacing, programs can create a more supportive environment for women to access SRHR services.
• TARGETED EDUCATION FOR BOYS: Educational programs should target boys from an early age, teaching them about gender equality, reproductive rights, and the importance of supporting their female peers in accessing SRHR services. Boys should be seen as key allies in promoting gender equality, and future programs should ensure their full participation.
5.1.2 More Targeted Programs for LGBTQI+ Communities
The SHE project made efforts to engage with LGBTQI+ communities; however, its strategic approach fell short in effectively addressing their unique needs. There was a lack of intentional planning and targeting to ensure meaningful engagement of LGBTQI+ individuals in project activities. Additionally, their participation was not systematically prioritized to inform the design and implementation of programs. This limited the project’s ability to develop tailored interventions that could adequately address the distinct challenges faced by LGBTQI+ communities.
Key Recommendation:
• DEVELOP A COMPREHENSIVE, TARGETED STRATEGY FOR LGBTIQ+ COMMUNITIES: Future programs should move beyond general gender-responsive services and implement deliberate, inclusive strategies to address the unique needs of LGBTIQ+ communities. This includes targeted outreach, tailored messaging, and inclusive service delivery models to reduce perceived stigma and ensure safe and supportive access to critical services like HIV testing and family planning.
5.1.3. Expansion of Adolescent-Friendly Health Services (AFHS)
The SHE project demonstrated the effectiveness of AFHFs in providing SRHR services to young people. However, the demand for these services exceeded the supply, particularly in rural and underserved areas. Future programs should focus on expanding the availability of adolescent-friendly health services to ensure that all young people can access the care they need.
Key Recommendations:
• EXPAND ACCESS TO AFHFS IN RURAL AREAS: Future programs should prioritize establishing additional AFHFs in underserved rural regions to address the lack of access to SRHR services. Mobile health units and community outreach initiatives should be implemented to extend the reach of these services to remote communities, ensuring that all adolescents can receive the care they need.
• EXPAND PROGRAMS TO INCLUDE 10-19 YEAR OLDS: Given the high proportion of teenagers in the target populations, future programming should specifically address the needs and challenges of adolescents aged 10-19. This age group is more amenable to change and has a significant role in future decision-making.
• INTEGRATE SRHR SERVICES INTO SCHOOLS: Schools provide an excellent opportunity to reach adolescents where they spend a significant portion of their time. Future initiatives should integrate AFHFs into schools, transforming them into hubs for SRHR education, counseling, and services. By collaborating with school administrations and the Department of Education, programs can facilitate regular workshops, symposiums, and awareness campaigns, creating a supportive environment for adolescents to access these essential services.
• STRENGTHEN TEACHER TRAINING FOR COMPREHENSIVE SEXUALITY EDUCATION (CSE): Teachers play a critical role in shaping adolescent attitudes and understanding of SRHR. Future programs should provide specialized training to equip teachers with the skills to deliver CSE effectively. These trainings should address gender biases, promote inclusion, and provide tools for challenging harmful norms while fostering respect for gender equality and sexual rights.
• REDUCE STIGMA AROUND SRHR SERVICES: Programs should focus on building trust among adolescents by enhancing adolescent-centered services, peer education programs, and confidential service pathways. Addressing stigma around contraceptive use and HIV testing requires consistent, youth-friendly communication and safe, supportive environments.
• ENGAGE PARENTS AS ADVOCATES FOR SRHR: Parents significantly influence adolescent decision-making and can play a pivotal role in supporting their children’s SRHR education and choices. Future programs should actively involve parents by creating platforms for open dialogue and equipping them with the tools to guide their children. Engaging parents in this way will help prevent issues like early marriages and empower adolescents to pursue education and personal growth.
• FOSTER MULTI-SECTORAL COLLABORATION: Future initiatives should adopt a multi-sectoral approach by engaging schools, parents, health providers, and local governments to create a comprehensive, inclusive framework for adolescent SRHR. Strengthening partnerships among these stakeholders will ensure that both educational institutions and communities are prepared to meet the growing demand for SRHR services and education.
5.1.4. Policy and Coordination Level Recommendations:
• Future programs should strongly advocate for the harmonization of government interventions on adolescent health across agencies such as the Commission on Population and Development, the Department of Education, and the Department of Health. This harmonization should include initiatives like the Adolescent Health and Development Program, Key Assistance for Developing Adolescent Networks, Teen Centers, and Comprehensive Sexuality Education (CSE).
• The integration of CSE into school curricula must be a critical agenda for future projects. Full implementation is still lacking, and policy advocacy is essential to ensure students receive the necessary knowledge and skills to make informed decisions about their sexual and reproductive health.
• Continued advocacy iswill be needed to advance the Adolescent Pregnancy Prevention Bill, currently stalled at the Senate level. Future projects must reinforce strategies to ensure the successful passage of this legislation, which has the potential to significantly improve adolescent health outcomes and prevent early pregnancies.
• AdvocacyIntensify efforts should be intensified to strengthen supply-side resources. Ensuring sufficient SRH commodities and resources in Rural Health Units (RHUs) and other distribution channels is critical to meeting the growing demand, especially in underserved and remote areas.
5.2. Design – Level Recommendations
• ALIGN PILLAR OUTCOMES FOR COHESION: Future program designs should ensure that the outcomes of Pillar 1 (community engagement) and Pillar 2 (organizational strengthening and advocacy) are fully aligned and contribute to the project’s overall goals. While Pillar 2 outcomes like CAT4SRHR enhanced Pillar 1 partners’ capacities, knowledge generation and advocacy outcomes lacked clear integration. Establishing mechanisms for regular communication and collaboration between the pillars will strengthen the impact. Co-designing the Theory of Change and implementing joint planning and reporting systems can ensure better synergy and amplify the program’s effectiveness.
• BALANCE BREADTH WITH DEPTH: Programs should strike a balance between broad outreach for widespread awareness and deep, sustained engagement to achieve meaningful impact on SRHR and GBV. Future designs should prioritize repeated, in-depth interactions with participants to foster lasting behavioral and social norm changes.
• INTEGRATE ECONOMIC EMPOWERMENT: SRHR program designs should incorporate economic empowerment initiatives to address financial barriers that prevent individuals, especially women and girls, from fully exercising their SRHR. These initiatives also support GBV survivors in breaking the cycle of abuse, creating pathways for independence and well-being.
• ENGAGE MEN AND BOYS WITH MEASURABLE TARGETS: Programs should deliberately target men and boys as participants in FP services and reproductive health. Future designs must include specific indicators to track their behavioral changes and participation, ensuring that shifts in attitudes lead to measurable outcomes in FP uptake and RHU visits.
• EXPAND ENHANCED USAPAN SERYE (Conversation Series): Future initiatives should scale up Enhanced Usapan Serye to balance awareness-raising and the provision of SRH services. Increasing the training pool for health service providers will ensure more communities gain access to both SRH knowledge and essential services.
5.3 Management-Level Recommendation
5.3.1. Strengthen Coordination Between Program Pillars
While the two-pillared approach of the SHE project was successful, there is room for stronger coordination between PILLAR 1 (COMMUNITY ENGAGEMENT) and PILLAR 2 (INSTITUTIONAL STRENGTHENING). In future programs, greater integration between these pillars will help ensure that changes achieved at the community level are reinforced by policy and institutional reforms.
Key Recommendations:
• REGULAR COORDINATION MEETINGS: Future programs should establish regular coordination meetings between community-based organizations and institutional partners to ensure alignment of efforts and maximize impact. These meetings will allow partners to share insights, identify synergies, and adjust strategies as needed.
• CROSS-PILLAR LEARNING: Facilitating cross-learning between Pillar 1 and Pillar 2 partners will help ensure that best practices from community-level work inform institutional advocacy efforts, and vice versa.
5.3.2. Improve Monitoring and Evaluation (M&E) Framework
The SHE project’s monitoring and evaluation framework could have been strengthened to provide more real-time insights into progress and areas for improvement. Future programs should prioritize the development of robust M&E systems that track both qualitative and quantitative indicators.
Key Recommendations:
• DEDICATED M&E PERSONNEL: Each partner organization should have dedicated M&E staff to ensure consistent data collection, analysis, and reporting. These staff members should be responsible for tracking the progress of project activities and ensuring that results are accurately reported.
• STANDARDIZED TOOLS AND METHODOLOGIES: Future programs should develop standardized tools for data collection across all project sites, ensuring that results are comparable and that best practices can be identified. M&E tools should include both qualitative and quantitative indicators to provide a comprehensive assessment of project outcomes.
CONCLUSION
The SHE project has achieved significant progress in improving sexual and reproductive health and rights (SRHR) in the Philippines, particularly for marginalized communities. The project’s comprehensive, two-pillar approach effectively addressed immediate community needs while driving long-term systemic changes through policy advocacy and capacity building.
Key achievements include a notable reduction in unmet family planning needs and teenage pregnancy rates, driven by expanded contraceptive distribution, culturally sensitive messaging, and the promotion of adolescentfriendly health services. Peer education and comprehensive sexuality education (CSE) played a pivotal role in engaging youth and shifting community attitudes toward SRHR. The project successfully challenged traditional gender norms by involving men in family planning decisions and promoting shared household responsibilities, leading to increased gender equality and a reduction in gender-based violence (GBV).
The SHE project also strengthened local women’s rights organizations (WROs) and civil society organizations (CSOs), improving their advocacy capabilities through the CAT4SRHR tool and capacity-building initiatives. These efforts resulted in the institutionalization of SRHR services within local health systems, ensuring sustainability beyond the project’s lifespan.
However, challenges remain, particularly regarding the sustainability of peer educators and the potential turnover of local government officials. The project’s reliance on external funding and volunteer efforts highlights the need for continued support to maintain these achievements. Overall, the SHE project laid a solid foundation for future SRHR initiatives and demonstrated the importance of long-term community engagement, cross-sector collaboration, and gender-sensitive health services in promoting SRHR and preventing GBV.